MHF-M16-2066

Patient presents to the ED for the following concerns: physical aggression, verbal agitation. Patient is court-ordered not to go home. He has a probation officer due to theft charges and assaulting his father in the spring. Patient was in a group home from May, until approximately three weeks ago, after making allegations of physical abuse by group home staff. Patient has been at The Bridge for Youth Shelter for three weeks. Patient became mad and started throwing things, became rough with others, and was unable to calm down. Patient has a potential group home placement, but it isn’t available until 11/14/23.

MCR-M16-1842

Long history of impulsive behavior and emotional dysregulation in the context of in utero substance exposure, prematurity, and repeated disruption of parental caregiver relationships. The current history suggests that he functioned fairly well over the last couple of years with relatively low level mental health services – highly experienced foster parent, individual therapy every 1-2 weeks, and occasional pharmacology. However, he began using cannabis more regularly and was unable to stop use when limits were set, leading to disruption of his foster placement. He has had significant dysregulation in a shelter and then crisis center setting since losing his foster home placement, including threatening peers, brandishing makeshift weapons, destroying property, and then finally physically attacking a peer (we do not have information about what provoked this) leading to his being sent to the ED. He has been consistently calm and polite here, though withdrawn, without evidence of clear active mood, psychotic, or anxiety disorder that would indicate a need for psychiatric hospitalization.